IDEAS home Printed from https://ideas.repec.org/a/spr/demogr/v56y2019i5d10.1007_s13524-019-00812-3.html
   My bibliography  Save this article

The Causal Effect of Maternal Education on Child Mortality: Evidence From a Quasi-Experiment in Malawi and Uganda

Author

Listed:
  • Liliana Andriano

    (University of Oxford)

  • Christiaan W. S. Monden

    (University of Oxford)

Abstract

Since the 1980s, the demographic literature has suggested that maternal schooling plays a key role in determining children’s chances of survival in low- and middle-income countries; however, few studies have successfully identified a causal relationship between maternal education and under-5 mortality. To identify such a causal effect, we exploited exogenous variation in maternal education induced by schooling reforms introducing universal primary education in the second half of the 1990s in Malawi and Uganda. Using a two-stage residual inclusion approach and combining individual-level data from Demographic and Health Surveys with district-level data on the intensity of the reform, we tested whether increased maternal schooling reduced children’s probability of dying before age 5. In Malawi, for each additional year of maternal education, children have a 10 % lower probability of dying; in Uganda, the odds of dying for children of women with one additional year of education are 16.6 % lower. We also explored which pathways might explain this effect of maternal education. The estimates suggest that financial barriers to medical care, attitudes toward modern health services, and rejection of domestic violence may play a role. Moreover, being more educated seems to confer enhanced proximity to a health facility and knowledge about the transmission of AIDS in Malawi, and wealth and improved personal illness control in Uganda.

Suggested Citation

  • Liliana Andriano & Christiaan W. S. Monden, 2019. "The Causal Effect of Maternal Education on Child Mortality: Evidence From a Quasi-Experiment in Malawi and Uganda," Demography, Springer;Population Association of America (PAA), vol. 56(5), pages 1765-1790, October.
  • Handle: RePEc:spr:demogr:v:56:y:2019:i:5:d:10.1007_s13524-019-00812-3
    DOI: 10.1007/s13524-019-00812-3
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s13524-019-00812-3
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s13524-019-00812-3?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Joshua D. Angrist & Alan B. Krueger, 2001. "Instrumental Variables and the Search for Identification: From Supply and Demand to Natural Experiments," Journal of Economic Perspectives, American Economic Association, vol. 15(4), pages 69-85, Fall.
    2. Esther Duflo, 2001. "Schooling and Labor Market Consequences of School Construction in Indonesia: Evidence from an Unusual Policy Experiment," American Economic Review, American Economic Association, vol. 91(4), pages 795-813, September.
    3. Horton, Susan, 1988. "Birth Order and Child Nutritional Status: Evidence from the Philippines," Economic Development and Cultural Change, University of Chicago Press, vol. 36(2), pages 341-354, January.
    4. Osili, Una Okonkwo & Long, Bridget Terry, 2008. "Does female schooling reduce fertility? Evidence from Nigeria," Journal of Development Economics, Elsevier, vol. 87(1), pages 57-75, August.
    5. Duncan Thomas, 1990. "Intra-Household Resource Allocation: An Inferential Approach," Journal of Human Resources, University of Wisconsin Press, vol. 25(4), pages 635-664.
    6. Shin-Yi Chou & Jin-Tan Liu & Michael Grossman & Ted Joyce, 2010. "Parental Education and Child Health: Evidence from a Natural Experiment in Taiwan," American Economic Journal: Applied Economics, American Economic Association, vol. 2(1), pages 33-61, January.
    7. Marshall Makate, 2016. "Education Policy and Under-Five Survival in Uganda: Evidence from the Demographic and Health Surveys," Social Sciences, MDPI, vol. 5(4), pages 1-17, October.
    8. Cleland, John G. & van Ginneken, Jerome K., 1988. "Maternal education and child survival in developing countries: The search for pathways of influence," Social Science & Medicine, Elsevier, vol. 27(12), pages 1357-1368, January.
    9. Terza, Joseph V. & Basu, Anirban & Rathouz, Paul J., 2008. "Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling," Journal of Health Economics, Elsevier, vol. 27(3), pages 531-543, May.
    10. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    11. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
    12. Li Chen & D. Y. Lin & Donglin Zeng, 2010. "Attributable fraction functions for censored event times," Biometrika, Biometrika Trust, vol. 97(3), pages 713-726.
    13. repec:fth:prinin:455 is not listed on IDEAS
    14. Sonalde Desai & Soumya Alva, 1998. "Maternal education and child health: Is there a strong causal relationship?," Demography, Springer;Population Association of America (PAA), vol. 35(1), pages 71-81, February.
    15. Basu, Alaka Malwade & Stephenson, Rob, 2005. "Low levels of maternal education and the proximate determinants of childhood mortality: a little learning is not a dangerous thing," Social Science & Medicine, Elsevier, vol. 60(9), pages 2011-2023, May.
    16. Lucia Breierova & Esther Duflo, 2003. "The Impact of Education on Fertility and Child Mortality: Do Fathers Really Matter Less Than Mothers?," OECD Development Centre Working Papers 217, OECD Publishing.
    17. Jorge M. Agüero & Prashant Bharadwaj, 2014. "Do the More Educated Know More about Health? Evidence from Schooling and HIV Knowledge in Zimbabwe," Economic Development and Cultural Change, University of Chicago Press, vol. 62(3), pages 489-517.
    18. Grépin, Karen A. & Bharadwaj, Prashant, 2015. "Maternal education and child mortality in Zimbabwe," Journal of Health Economics, Elsevier, vol. 44(C), pages 97-117.
    19. Frost, Michelle Bellessa & Forste, Renata & Haas, David W., 2005. "Maternal education and child nutritional status in Bolivia: finding the links," Social Science & Medicine, Elsevier, vol. 60(2), pages 395-407, January.
    20. Rosenzweig, Mark R & Schultz, T Paul, 1989. "Schooling, Information and Nonmarket Productivity: Contraceptive Use and Its Effectiveness," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 30(2), pages 457-477, May.
    21. Kenneth Bollen & David Guilkey & Thomas Mroz, 1995. "Binary outcomes and endogenous explanatory variables: Tests and solutions with an application to the demand for contraceptive use in tunisia," Demography, Springer;Population Association of America (PAA), vol. 32(1), pages 111-131, February.
    22. Joshua Angrist & Alan Krueger, 2001. "Instrumental Variables and the Search for Identification: From Supply and Demand to Natural Experiments," Working Papers 834, Princeton University, Department of Economics, Industrial Relations Section..
    23. Makate, Marshall & Makate, Clifton, 2016. "The causal effect of increased primary schooling on child mortality in Malawi: Universal primary education as a natural experiment," Social Science & Medicine, Elsevier, vol. 168(C), pages 72-83.
    24. Hatt, Laurel E. & Waters, Hugh R., 2006. "Determinants of child morbidity in Latin America: A pooled analysis of interactions between parental education and economic status," Social Science & Medicine, Elsevier, vol. 62(2), pages 375-386, January.
    25. Julia Behrman, 2015. "Does Schooling Affect Women’s Desired Fertility? Evidence From Malawi, Uganda, and Ethiopia," Demography, Springer;Population Association of America (PAA), vol. 52(3), pages 787-809, June.
    26. Wolfe, Barbara L. & Behrman, Jere R., 1987. "Women's schooling and children's health : Are the effects robust with adult sibling control for the women's childhood background?," Journal of Health Economics, Elsevier, vol. 6(3), pages 239-254, September.
    27. Paul Glewwe, 1999. "Why Does Mother's Schooling Raise Child Health in Developing Countries? Evidence from Morocco," Journal of Human Resources, University of Wisconsin Press, vol. 34(1), pages 124-159.
    28. World Bank, 2009. "Abolishing School Fees in Africa : Lessons from Ethiopia, Ghana, Kenya, Malawi, and Mozambique," World Bank Publications - Books, The World Bank Group, number 2617, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jona Schellekens, 2021. "Maternal education and infant mortality decline: The evidence from Indonesia, 1980–2015," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 45(24), pages 807-824.
    2. Crawfurd, Lee, 2024. "Feasibility first: Expanding access before fixing learning," International Journal of Educational Development, Elsevier, vol. 104(C).
    3. Tadadjeu, Sosson & Njangang, Henri & Asongu, Simplice A. & Kamguia, Brice, 2023. "Natural resources, child mortality and governance quality in African countries," Resources Policy, Elsevier, vol. 83(C).
    4. Swati Dutta, 2022. "Risk factors for child survival among tribal dominated states in India: a pooled cross sectional analysis," Journal of Population Research, Springer, vol. 39(3), pages 391-416, September.
    5. Martin Mwale & Dieter von Fintel & Anja Smith, 2022. "School drop out and farm input subsidies: gender and kinship heterogeneity in Malawi," Working Papers 01/2022, Stellenbosch University, Department of Economics.
    6. Agyen, Vida Afarebea & Annim, Samuel Kobina & Asmah, Emmanuel Ekow, 2024. "Neighbourhood mothers’ education and its differential impact on stunting: Evidence from 30 Sub-Saharan African countries," Social Science & Medicine, Elsevier, vol. 340(C).
    7. Shuang Chen, 2022. "The Positive Effect of Women’s Education on Fertility in Low-Fertility China," European Journal of Population, Springer;European Association for Population Studies, vol. 38(1), pages 125-161, March.
    8. Aurino, Elisabetta & Lleras-Muney, Adriana & Tarozzi, Alessandro & Tinoco, Brendan, 2023. "The rise and fall of SES gradients in heights around the world," Journal of Health Economics, Elsevier, vol. 91(C).
    9. Maame Esi Woode & Duncan Mortimer & Rohan Sweeney, 2021. "The impact of health sector‐wide approaches on aid effectiveness and infant mortality," Journal of International Development, John Wiley & Sons, Ltd., vol. 33(5), pages 826-844, July.
    10. Nguyen-Phung, Hang Thu, 2023. "The impact of maternal education on child mortality: Evidence from an increase tuition fee policy in Vietnam," International Journal of Educational Development, Elsevier, vol. 96(C).
    11. Paul, Sohini & Paul, Sourabh & Gupta, Ashish Kumar & James, K.S., 2022. "Maternal education, health care system and child health: Evidence from India," Social Science & Medicine, Elsevier, vol. 296(C).
    12. Hanbo Wu, 2022. "The Effect of Maternal Education on Child Mortality in Bangladesh," Population and Development Review, The Population Council, Inc., vol. 48(2), pages 475-503, June.
    13. Marie Christelle Mabeu & Roland Pongou, 2021. "The Interplay Between Colonial History and Postcolonial Institutions: Evidence from Cameroon," Working Papers 2111E Classification-D02,, University of Ottawa, Department of Economics.
    14. Sory Toure & John Weeks & David Lopez-Carr & Douglas Stow, 2020. "Evaluating links between dynamic urban landscapes and under-five child mortality in Accra, Ghana," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 42(20), pages 589-614.
    15. Karen G. Añaños Bedriñana & José Antonio Rodríguez Martín & Fanny T. Añaños, 2021. "Human Rights in the Least Developed Countries of Asia: An Index for Quantifying Sustainable Development Goal 3 (Good Health and Wellbeing)," IJERPH, MDPI, vol. 18(9), pages 1-17, April.
    16. Breen, Richard & Ermisch, John, 2021. "Instrumental Variable Estimation in Demographic Studies: The LATE interpretation of the IV estimator with heterogenous effects," SocArXiv vx9m7, Center for Open Science.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Makate, Marshall & Makate, Clifton, 2016. "The causal effect of increased primary schooling on child mortality in Malawi: Universal primary education as a natural experiment," Social Science & Medicine, Elsevier, vol. 168(C), pages 72-83.
    2. Marshall Makate, 2016. "Education Policy and Under-Five Survival in Uganda: Evidence from the Demographic and Health Surveys," Social Sciences, MDPI, vol. 5(4), pages 1-17, October.
    3. Agyen, Vida Afarebea & Annim, Samuel Kobina & Asmah, Emmanuel Ekow, 2024. "Neighbourhood mothers’ education and its differential impact on stunting: Evidence from 30 Sub-Saharan African countries," Social Science & Medicine, Elsevier, vol. 340(C).
    4. Le, Kien & Nguyen, My, 2020. "Shedding light on maternal education and child health in developing countries," World Development, Elsevier, vol. 133(C).
    5. Hanbo Wu, 2022. "The Effect of Maternal Education on Child Mortality in Bangladesh," Population and Development Review, The Population Council, Inc., vol. 48(2), pages 475-503, June.
    6. Mustafa Özer & Jan Fidrmuc & Mehmet Ali Eryurt, 2017. "Does Maternal Education Affect Childhood Immunization Rates? Evidence from Turkey," CESifo Working Paper Series 6439, CESifo.
    7. Bahadır Dursun & Resul Cesur & Inas R. Kelly, 2022. "Mandatory Schooling of Girls Improved Their Children's Health: Evidence from Turkey's 1997 Education Reform," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 41(3), pages 824-858, June.
    8. Frederik Wild & David Stadelmann, 2024. "Heterogeneous Effects of Women's Schooling on Fertility, Literacy and Work: Evidence from Burundi's Free Primary Education Policy," Journal of African Economies, Centre for the Study of African Economies, vol. 33(1), pages 67-91.
    9. Rachel Heath & Seema Jayachandran, 2016. "The Causes and Consequences of Increased Female Education and Labor Force Participation in Developing Countries," Working Papers id:11434, eSocialSciences.
    10. Justin McCrary & Heather Royer, 2011. "The Effect of Female Education on Fertility and Infant Health: Evidence from School Entry Policies Using Exact Date of Birth," American Economic Review, American Economic Association, vol. 101(1), pages 158-195, February.
    11. Jayanta Kumar Bora & Rajesh Raushan & Wolfgang Lutz, 2018. "Contribution of Education to Infant and Under-Five Mortality Disparities among Caste Groups in India," VID Working Papers 1803, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna.
    12. Keats, Anthony, 2018. "Women's schooling, fertility, and child health outcomes: Evidence from Uganda's free primary education program," Journal of Development Economics, Elsevier, vol. 135(C), pages 142-159.
    13. Bahadir Dursun & Resul Cesur & Inas Rashad Kelly, 2017. "The Value of Mandating Maternal Education in a Developing Country," NBER Working Papers 23492, National Bureau of Economic Research, Inc.
    14. Vinish Shrestha, 2016. "Can Basic Maternal Literacy Skills Improve Infant Health Outcomes? Evidence from the Education Act in Nepal," Working Papers 2016-08, Towson University, Department of Economics, revised Jan 2019.
    15. Baltagi, Badi H. & Flores-Lagunes, Alfonso & Karatas, Haci M., 2019. "The effect of education on health: Evidence from the 1997 compulsory schooling reform in Turkey," Regional Science and Urban Economics, Elsevier, vol. 77(C), pages 205-221.
    16. Marshall Makate & Chamunorwa Nyamuranga, 2023. "The long‐term impact of education on dietary diversity among women in Zimbabwe," Review of Development Economics, Wiley Blackwell, vol. 27(2), pages 897-923, May.
    17. Nguyen-Phung, Hang Thu, 2023. "The impact of maternal education on child mortality: Evidence from an increase tuition fee policy in Vietnam," International Journal of Educational Development, Elsevier, vol. 96(C).
    18. Samia Badji, 2016. "Mother's Education and Increased Child Survival in Madagascar: What Can We Say?," Working Papers 1635, Groupe d'Analyse et de Théorie Economique Lyon St-Étienne (GATE Lyon St-Étienne), Université de Lyon.
    19. Musaddiq, Tareena & Said, Farah, 2023. "Educate the girls: Long run effects of secondary schooling for girls in Pakistan," World Development, Elsevier, vol. 161(C).
    20. Bellés-Obrero, Cristina & Cabrales, Antonio & Jiménez-Martín, Sergi & Vall-Castelló, Judit, 2023. "Women’s education, fertility and children’ health during a gender equalization process: Evidence from a child labor reform in Spain," European Economic Review, Elsevier, vol. 154(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:demogr:v:56:y:2019:i:5:d:10.1007_s13524-019-00812-3. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.